1279P - Prevalence of EGFR mutations (EGFRm) in patients (pts) with resected stage I-III NSCLC: Results from EARLY-EGFR LATAM

Background

Targeted and immune-therapies are currently recommended in early-stage NSCLC. However, biomarker prevalence data are limited in Latin America (LATAM). EARLY-EGFR (NCT04742192) determined the frequency of EGFRm in pts with resected stage I-III NSCLC across Asia, Middle East and Africa and LATAM.

Methods

The LATAM subset of this descriptive, observational, real-world study prospectively enrolled consecutive pts with surgically-resected stage IA-IIIB (AJCC 8^th edi.) non-squamous NSCLC from Mar 2021-Oct 2022. Primary endpoint was EGFRm prevalence and secondary endpoints were EGFRm subtypes, clinico-demographics and treatment patterns. Association between EGFRm and clinico-demographic factors was assessed by Fisher's exact test with Monte Carlo.

Results

80 pts were enrolled with mean±SD age of 66.5±9.7 yrs; 67.5% females and 57.5% never smokers. All pts had adenocarcinoma. Pathological stage (PS) distribution was PS I 66.3%, PS II 20.0% and PS III 13.8%. Most pts (61.3%) had right lung involvement and 85.0% were pN0. EGFRm prevalence was 39.5% (30/76) with similar rates in males and females (39.1% vs 39.6%; Table). Exon-19 deletions (36.7%) and 21-L858R (30.0%) accounted for two-thirds of mutations. 4 of 11 (36.4%) pts with EGFRm were found to be PD-L1 positive. EGFRm rate in never smokers was significantly higher than in current and former smokers (51.2% vs 24.2%, p=0.017). 76.3% underwent only surgical resection. Of 44 PS IB-IIIB pts, 31.8% received systemic adjuvant therapy (AT), mostly platinum-based chemotherapy. Per logistic regression analysis age ≥60 years had increased odds of EGFRm, while smokers had decreased odds of EGFRm (both p<0.05).

Table: 1279P

EGFRm in the LATAM cohort

Note: Four pts failed EGFR test ^aBy smoking history (current and former vs never; p=0.017) Countries: Argentina, Chile, Colombia, Costa Rica, Dominican Republic, Mexico and Peru

Conclusions

The LATAM subset shows a EGFRm prevalence of 39.5%. Despite ASCO guidelines recommending AT in PS IB-IIIB, only about 32% received it. Our results are important for guiding EGFR testing and informing treatment strategies in LATAM with recent and upcoming approvals of targeted and immune-therapies.

Clinical trial identification

NCT04742192.

Editorial acknowledgement

Medical writing assistance was provided by Prajakta Nachane (M Pharm) of Labcorp Scientific Services & Solutions Pvt. Ltd. funded by AstraZeneca.

Legal entity responsible for the study

AstraZeneca.

Funding

AstraZeneca.

Disclosure

E. Amorin: Financial Interests, Institutional, Local PI: Clínica Delgado Auna. H.A. Perroud: Financial Interests, Institutional, Steering Committee Member: Sanatorio de la Mujer. L.G. Hellal: Financial Interests, Institutional, Local PI: Fundación Santa Fé. S.V. Francisco: Financial Interests, Institutional, Local PI: Clínica Santa María. A.P. Guerrero: Financial Interests, Institutional, Local PI: Instituto Nacional del Cáncer Rosa Emilia Sánchez Pérez de Tavares. A. Vasquez: Financial Interests, Institutional, Local PI: Mediadvance. L.F.T. Gallegos, N. Donner, R. Huggenberger: Financial Interests, Institutional, Full or part-time Employment: AstraZeneca. L. Corrales: Financial Interests, Institutional, Local PI: Centro de Investigación y Manejo del Cáncer.